6 Tips for Healthy Eating With Chronic Lymphocytic Leukemia

Eating healthfully and boosting your calorie intake can help support your treatment.

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By Emily Willingham

When you have chronic lymphocytic leukemia (CLL)—a type of cancer that starts from cells in the bone marrow and moves into the blood—your food choices are critical to shoring up your defenses and supporting your treatment. It’s smart to focus on two key areas: eating enough and eating safely.

Eating enough can become a problem when the side effects from treatment—or from simply feeling unwell—dampen your appetite. During treatment, you may experience a change in your sense of taste that may turn you away from your favorite foods. Or you might experience nausea that makes eating difficult. Although both issues may resolve with time, maintaining your weight when you have nausea or loss of taste can be a challenge and may require some intentional eating.

Food safety is always important but becomes even more so when your immune system is compromised. With cancer and cancer treatment, your embattled immune system doesn’t need any more challenges. That’s why you should avoid some foods entirely and exercise care in preparing others. Eating out can also pose special difficulties: you’ll need to be even more cautious about which foods you choose. Here are a few more essentials to keep in mind.

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Eat small but often

When you’re having treatment for CLL or just feeling unwell, getting enough calories can be tough. But it’s vital to keep up your intake to maintain energy levels and avoid losing too much weight. Eating several small meals and high-calorie snacks throughout the day (rather than trying to get down three big ones) can help.

This tactic can also help when you’re dealing with changes in taste sensation along with a reduced appetite. Discussing your options with a dietitian may also help you select smart options for your frequent, smaller meals.

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Handle raw foods with care

Raw fruits and vegetables require a thorough washing. Uncooked tofu, raw honey, shellfish, sushi or sashimi as well as raw vegetable sprouts or alfalfa all pose a microbial threat that is even more dangerous for people with cancer or for those undergoing cancer treatment. Like dairy products, fruit juices should be pasteurized.

Another concern with raw foods, especially meats, is cross-contamination. Washing hands thoroughly after handling raw meat, using different preparation tools for raw meats and other foods, and storing raw foods separately from ready-to-eat foods can all help reduce the chance of transmitting harmful microbes.

Meats, of course, require thorough cooking. Beef, lamb and pork should be cooked to an internal temperature of 160°F; chicken and other poultry to 165°F. You can buy a digital thermometer and use it to measure temperature at the thickest part of the meat. Heat casseroles to 165°F and don’t forget to warm processed meats like hot dogs and lunch meats until they’re steaming. Any leftovers should be refrigerated promptly.

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Boost calories with add-ons

You can slip extra calories into your daily diet by mixing protein powders or supplements into yogurt, shakes or smoothies. For recipes calling for milk, try subbing in whole milk or half-and-half. Having a milkshake between meals can also give you a calorie boost, as can adding butter, cheese or cream sauces to meals.

You can also boost the calorie impact of healthy snacks by adding dried fruits or roasted nuts or by stirring in or slathering on nut butters (think peanut, almond or cashew). Supplemental nutrition drinks or bars may also be helpful.

Before taking any of these steps, of course, it’s always smart to consult a dietitian or your healthcare provider. Depending on your situation, your healthcare provider may also recommend taking vitamins.

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Cook eggs completely for safety

Packed with nutrition, eggs can be a great way to add fat, protein and calories to your day. But they also can be carriers of Salmonella, a type of bacteria that can cause significant illness. Your immune system doesn’t need to deal with Salmonella and neither do you, so be sure to cook both white and yolk until solid, not runny.

It’s also wise to avoid foods that may contain raw eggs, such as hollandaise sauce. Raw eggs may also be hiding in some unexpected places, including cheesecake, homemade mayonnaise and some Caesar salad dressings. In fact, when it comes to dressings, it’s best to avoid the grocery store refrigerator options and go with shelf-stable bottled varieties.

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Manage liquids carefully

Drinking a lot of fluids before eating can fill you up quickly, so it’s smart to limit your liquid intake before meals. One liquid you might want to ask your healthcare provider about is a glass of wine or beer with your food. An occasional drink may work as a stimulant to your appetite.

But don’t restrict your overall fluid intake between meals, however. It’s important to stay hydrated throughout the day. Shoot for at least eight 8-ounce glasses of fluid per day. Fruit juices count, too, as long as they’re pasteurized, and they can also provide extra calories you might need.

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Choose only pasteurized dairy foods

As with eggs, soft cheeses and unpasteurized dairy products may carry bacteria that can cause disease. Check for the word “pasteurized” on all dairy products and avoid blue-veined soft cheeses, such as Stilton, and Latin American-style soft cheeses, such as queso blanco or queso fresco.

What cheeses can you eat? Hard cheeses (such as cheddar and Romano) are fine, as are pasteurized cottage cheese or mozzarella and any pasteurized cheese spreads. As long as it’s safely pasteurized, cheese can be a good way to boost calories when added to meals and snacks, whether melted over meats or vegetables, or stirred into sauces.